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Using Psychology with Energy Psychology Approaches: Discussion and sharing of clinical components

© 2014 John H. Diepold, Jr., Ph.D., DCEP

16th Annual International Energy Psychology Conference

June 1, 2014; Phoenix, AZ

Presentation Abstract: While use of Energy Psychology (EP) principles and methods have morphed into an ever- expanding domain of applications and practitioners, the roots are in the practice of clinical psychology and psychotherapy. This presentation will serve to highlight and discuss various psychological clinical skills, methods, and tools to enhance the foundation and effectiveness of EP applications across multiple areas of practice (e.g., psychotherapy, counseling, coaching). While there may be many ways to go about providing mental/health care, research and experience suggest that some helping methods can be more effective and quicker than others. Part of the draw to EP methods relates to the novel and alternative ways that treatment is engaged and the relatively quick treatment outcomes by skillful practitioners. This serves to be attractive to both practitioner and client/patient. However, in most circumstances, EP methods are not stand-alone approaches, and to think of these as such can lead to challenging situations and reduced effectiveness. The newer the person is to using and/or receiving EP treatments the more likely the risk of jumping into treatment prematurely. This session will focus on clinical values, ethics, and tools regarding patience, evidenced-based therapist qualities, acquiring background information, establishing rapport, treatment planning, and if/when to refer, all of which needs to complement skills in EP approaches. The role of the clinician in psychotherapy: Some examples of what psychological literature advocates?

“Current psychotherapy researchers have come to the conclusion that it is the relationship that is the most salient component for successful psychotherapy.”

(Vivino & Thompson, 2013; p.20) Vivino and Thompson (2013) remind us that in this era of contemporary psychotherapy methods with “cool” names (e.g., post-modern, constructivist, mindfulness, positive psychology, DBT, CBT, Energy Psychology), it is the therapeutic relationship that sets the stage regardless of theoretical orientation and methodology. The client-centered therapeutic model involving empathy, understanding, and a non-judgmental and non-pathological stance with the individual has been around since the 1960s as espoused by psychologist Carl Rogers (1961). This Humanistic component of psychotherapy also incorporates the notion of connectedness where a person can be free to flourish, and to

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“live fully in each moment” (Rogers, 1961; p. 188), which relates to “mindfulness” in present-day practices. From the viewpoint involving the role of attachment related issues (Wallin, 2007), it is important (especially when there is a history of trauma) to provide a safe and secure environment, which can be accomplished by the therapist being emotionally present, resonating to the client in kind, and non-judgmental as reflected in the Rogerian constructs of empathy, unconditional positive regard, congruence, and genuineness. Neurobiological evidence now documents the value of mindful “presence”, awareness, attunement, and resonance in fostering a safe and healing environment by the therapist and for the client (Siegel, 2010; Vivino & Thompson, 2013). Psychologist, Bruce Wampold (2007), recipient of APA’s 2007 Award for Distinguished Professional Contributions to Applied Research, opines that the healing change process in psychotherapy also involves an adaptive and/or functional explanation of the problem, and treatment consistent with the explanation that leads to improved adaptive functioning. The humanistic, client-centered connection is essential in effective psychotherapy and is supported by research.

“Research has shown that these variables related to interpersonal process are robust predictors of outcome and are likely causally involved in producing the benefits of psychotherapy…It appears that the focus on the therapeutic interaction as the critical aspect of psychotherapy is justified by the research evidence.” (Wampold, 2007; p. 869)

Dr. Wampold writes further that,

“Effective therapists are skilled at monitoring acceptance of the explanation and the treatment and will modify the delivery of an explanation as necessary.” (p. 864)

Overview of important therapist traits to promote effective psychotherapy: (as reported by the sample of authors listed above and in the Reference section) In no particular order… Empathy Understanding Non-judgmental Non-pathologizing Caring Genuineness Emotionally Present Attentive Perceptive Compassionate Safe Secure/Grounded Unconditional Positive Regard Attunement Congruence Resonance Realism It is my belief that both the above therapist qualities and therapeutic outcomes can be enhanced by some of the EP methods and approaches. Regardless of your approach,

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when you and your client/patient are comfortable with one another and the method, then a state of coherent resonance and healing change becomes possible. The Therapeutic Relationship The psychotherapeutic relationship between the therapist and the individual is of upmost importance. While the reader is free to examine the current literature, my aim is to address some of the pragmatic factors I have identified with regard to psychotherapy in general and HAT and other EP approaches in particular. When initiating a therapeutic relationship, the most fundamental requirement is to first be a person, and a therapist second. Our personhood is the common connective denominator that sets the stage for all that follows in psychotherapy. If the individual is unable to connect with you as a person it becomes a greater challenge to become part of his or her experience for the purpose of healing and change. Being genuine in our interactions, caring, and intentions to assist a person encompasses a large degree of what be a person entails. In most instances, the individual already knows that the therapist possesses appropriate credentials to provide the assistance they seek. Accordingly, how we act, speak, and go about gathering initial background information reveals our “professionalism”, which can be done with interest, care, concern, hope, and realistic optimism. There is a much better chance that the individual will want to work with you when he or she feels understood, heard, and comfortable when sharing the darkest of concerns. Just as we have learned to notice the verbal and the non-verbal communications, remember that the individual also does the same. Integrating the Therapeutic Relationship and the HAT Model (or EP Models) After establishing a workable relationship with the individual, and background information is sufficiently obtained (e.g., reasons for seeking assistance, relevant precursor and trigger components of concerns/symptoms, social history, etc.), now the treatment strategies and psychotherapeutic methods come into play. In many instances the individual has been in psychotherapy before. When this is the case I find it helpful to learn what his or her experiences had been, what approaches were used, and how they may have benefited. The HAT model and many EP approaches go beyond what most individuals believe “talk therapy” is all about. While the therapist uses all of his or her “talk therapy” skills, when the target issue becomes clear that is the time to specify a treatment focus and “go to work”. Figure A conceptualizes a psychotherapy session in which HAT or EP methods are used. As can be seen, Phases 1 and 3 are more classic “talk therapy” components and Phase 2 is the HAT or EP intervention. The therapist is free to adjust the time needed to converse and/or prepare the individual in Phase 1 before starting the intervention. Sometimes this is time for the usual “updates” since last session and/or clarification of the targeted issue (Treatment Focus) on which HAT or EP methods will be used. This can be 10 to 20 minutes at the therapist’s discretion. During this time the therapist can

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use any warranted psychotherapeutic approaches given the content of the information shared and the affect and stability of the individual. Sometimes the session never progresses beyond this phase due to the individual’s needs or circumstances at that time as assessed by the therapist. Therefore, a Phase 1 only session would mirror a more typical talk therapy session in which support, information gathering, reframing, and other psychotherapy modalities are used. As always, the what, when, and how to intervene and assist the individual remains a clinical judgment by the therapist. Upon completion of Phase 1, I literally say, “Ready to go to work?” This is my segue into Phase 2, which is the HAT or EP intervention. The HAT or EP phase typically runs from 10 to 25 minutes. Sometimes issues unfold and shift in a relatively brief amount of time while other issues take longer (i.e., extending over several sessions). I have given up guessing how long treatment on a particular Treatment Focus will take. When I thought an issue would be completed quickly it took longer, and when I thought an issue would take longer it processed through quickly! I have found no way to predict. My stance has become “It will take the amount of time needed…it is what it is.” I also use an individual’s query about how long will the treatment take as an opportunity to explain more about HAT or EP approaches using images, metaphors, and/or magnets. For example, I might explain that the shock of their experience was like a large rock being thrust into a still pond. At first there is the noise of the splash and the ripples in the water. However, the rock also displaces air, causing lots of tiny bubbles to more slowly float upward to the surface. We keep working with HAT or EP approaches until there are no more bubbles… Phase 3 is a check-in and wind down time after the intervention is completed for the session. Upon completion of the intervention I always thank the individual for his or her cooperation and courage in doing the work. Yes, courage is recognized and appreciated. Practicing Psychotherapy in an Evidenced-Based Environment Just as the client/patient must become courageous to confront his or her issues and experiences, we therapists must also become courageous with appropriate clinical judgment. When Behavioral Kinesiology (Diamond, 1979) and Thought Field Therapy (Callahan, 1981;1985) first hit the psychotherapy scene integrating techniques from Applied Kinesiology and Traditional Chinese Medicine, learning and using these methods required courage and conviction. The reality is that we only learn the efficacy of an approach by learning, doing, and studying it. However, when one attempts to throw out a hundred years of evolving psychotherapy methods, use only a new method, and even state that research was not necessary, the early movement only positioned itself into the headwinds of a professional Category 5 hurricane! Combining this with insurance care-management initiatives and an unrelenting “old guard” in psychotherapy, we end up with the onset of evidenced-based practice in the mental health communities. Psychologist, Tracy Eells (2011) reminds us that the American Psychological Association’s 2005 task force on Evidence-Based Practice in Psychology (EBPP) reported that, “EBPP is defined as ‘the integration of the best available research with

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clinical expertise in the context of patient characteristics, culture, and preferences” and that “EBPP ‘promotes effective psychological practice and enhances public health by applying empirically supported principles of psychological assessment, case formulation, therapeutic relationship, and intervention”. Eells contends “case formulation” is at the center of EBPP, and again references the APA report: “Although clinical practice is often eclectic or integrative…and many effects of psychological treatment reflect nonspecific aspects of therapeutic engagement…, psychologists rely on well-articulated case formulations, knowledge of relevant research, and the organization provided by theoretical conceptualizations and clinical experience to craft interventions designed to attain desired outcomes”. (Eells, 2011; p17) Accordingly, case formulation may also be at the center of integrating use of EP methods when providing mental health and coaching services. Bottom line: Do your due diligence and gather information about your patient/client, establish a comfortable rapport, use your information about the individual, learn what he or she wants in treatment and what is getting in the way, use your clinical experience, knowledge of research, and best judgment to discuss and craft an intervention that best suits the needs and desired outcome of the individual. This form of documented case formulation will assist you in thriving in an evidenced-based environment. Sample of an Intake Forms for Gathering Background Information Feel free to copy, change, and use the Intake form in any meaningful way! Consider beginning with page 5 of the Intake below. Discover why they are coming into treatment. Why now? What are his or her expectations, goals, etc. I do the complete intake in person during the first session or over the following sessions depending on the individual, their background, and how extensive the circumstances. This information gathering process can also reveal much about the person that is unsaid, and fosters the connecting process in building a desirable rapport.

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Figure A

Format of a Psychotherapy Session

The “One-Hour” Session

Start of Session Selected Intervention End of Session

Psychotherapy, counseling, and coaching almost always entail more than just the administration of a technique or model of treatment. We have learned much during our training and experience as clinicians and helpers, and we ought to continue to make space before and after a specific intervention for these clinical skills in relating to the individual who seeks our assistance.

TFT EFT TAT HAT

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Clinical Considerations Remember to be mindful of your personal and professional clinical values and ethics when agreeing to take an individual into treatment. Do you have the needed training and/or experience for the needs of the individual? Do you want/need supervision? Do you want/need to refer the individual to someone else? Be patient. Allow your treatment planning to unfold and build around the acquired information and your relationship with the individual relative to your areas of expertise. Be mindful in your case conceptualization regarding a past-present-future orientation. In other words, be simultaneously mindful of his or her past in the present as you influence their future. References Callahan, R.J. (1981). Psychological reversal. In Collected papers of the International College of Applied Kinesiology (p. 79-96). Shawnee Mission, KS: International College of Applied Kinesiology. Callahan, R.J. (1985). Five-minute phobia cure: Dr. Callahan’s treatment for fears, phobias and self-sabotage. Wilmington, DE: Enterprise. Diamond, J. (1979). Behavioral kinesiology. New York: Harper & Row. Dunn, R., Callahan, J.L., and Swift, J.K. (2013). Mindfulness as a transtheoretical clinical process. Psychotherapy. 50 (3), 312-315. doi:10.1037/a0032153 Eells, T.D. (2011). What is an evidenced-based psychotherapy case formulation? Psychotherapy Bulletin, 46 (2), 17-21. Goldfried, M.R. (2013). Integrating research and practice: Some results of the two-way bridge initiative. Psychotherapy Bulletin, 48 (3), 5-7. Geller, S. & Pos, A. (2012). Therapeutic presence: A fundamental common factor in the provision of effective psychotherapy. Psychotherapy Bulletin, 47 (3), 6-13. Orellana, B.I.P. and Gelso, C.J. (2013). What does the therapist bring to the relationship? The connections among real relationship, countertransference, and attachment. Psychotherapy Bulletin, 48 (2), 12-16. Rogers, C. (1961). On becoming a person: A therapist’s view of psychotherapy. London: Constable. Siegel, D.J. (2010). The mindful therapist: A clinician’s guide to mindsight and neural integration. New York: W.W. Norton.

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Swift, J.K. (2012). Training in the art of psychotherapy. Psychotherapy Bulletin, 47 (4), 20-23. Vivino, B.L. & Thompson, B.J. (2013). Musings from the psychotherapy office: A “cool” clinical approach. Psychotherapy Bulletin, 48 (4), 18-20. Wampold, B.E. (2007). Psychotherapy: The humanistic (and effective) treatment. American Psychologist, 62 (8), 857-873. Wallin, D. (2007). Attachment in psychotherapy. New York: The Guilford Press.